X12 Ingest & Denial Analytics

Demo Environment — Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Members›policy B08M000243›MARCUS JOHNSON

MARCUS JOHNSON

Dependent on policy B08M000243

Claims
1
Attributed to this person
Charged
887.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
0.00
Reported on the 835

Patient responsibility is the amount reported on the 835 as assigned to the patient — deductible, coinsurance or copay. It is not proof that the provider billed the member, that the member owes it, or that it was collected, and it is kept separate from denied amounts throughout.

Who this is

FieldValue
NameMARCUS JOHNSON
Role on the policyDependent · relationship 19
PolicyB08M000243
Date of birth17 Feb 2005
PlanSILVER HMO
Covered from26 Jul 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000109813 Feb 2025887.00MERIDIAN HEALTH PLANNot denied—